糜烂Erosion · 腺胃 · 消化系统 · NTP ntp-0278

依据美国国家毒理学计划(NTP)Nonneoplastic Lesion Atlas 整理 · 中文译文与诊断建议 · 仅供科研使用,不用于临床诊断

一句话结论:在小鼠和F344/N大鼠的NTP研究中,腺胃糜烂的自发性发生不常见。糜烂主要见于处理组大鼠。
诊断要点:腺胃糜烂应予以诊断,并根据病变的范围和分布进行分级。水肿、炎症和邻近上皮的增生不应单独诊断,除非它们是病变的显著组成部分。

病变描述

在小鼠和F344/N大鼠的NTP研究中,腺胃糜烂的自发性发生不常见。糜烂主要见于处理组大鼠。糜烂(Figure 1、Figure 2)是部分厚度的上皮缺失,相比之下,溃疡(见Stomach, Glandular Stomach - Ulcer)则是整个上皮厚度缺失,深达或穿透基底膜和黏膜肌层。相比之下,如果上皮的坏死部分仍然存在并至少部分附着于其下方存活的上皮,则应诊断为上皮坏死而非糜烂。细菌感染可继发于糜烂或溃疡,原因包括灌胃操作造成的局部创伤或坏死/缺血。大鼠胃内的固有细菌通常仅见于附着于最靠近管腔的黏膜表面,而不存在于胃小凹中。发生糜烂/溃疡后,细菌可进入黏膜和胃壁的更深部位。产生糜烂和溃疡的化合物可通过影响黏膜血流、黏膜细胞动力学、黏液或酸/碳酸氢盐分泌,或维持黏液屏障而发挥作用。高脂饮食、慢性泛酸缺乏、生糖氨基酸缺乏、血小板活化因子、胆汁盐反流增加以及外分泌胰腺功能降低与溃疡形成相关,但仅在迷走神经支配完整时如此。溃疡形成的介质可能是花生四烯酸代谢的脂氧合酶途径的代谢产物。据报道,大鼠幼仔与母鼠分离的日龄会影响其对制动应激诱导的胃糜烂发生的易感性。

诊断与分级建议(NTP 共识)

腺胃糜烂应予以诊断,并根据病变的范围和分布进行分级。水肿、炎症和邻近上皮的增生不应单独诊断,除非它们是病变的显著组成部分。如果坏死上皮仍然存在并至少部分附着于其下方存活的上皮,则应诊断为上皮坏死而非糜烂。相关链接:Stomach, Glandular Stomach - Ulcer

图谱

糜烂(腺胃)组织学图谱 1
图 1 · 糜烂 · 来源:NTP NNL Atlas
糜烂(腺胃)组织学图谱 2
图 2 · 糜烂 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
Spontaneous occurrence of erosion of the glandular stomach is uncommon in NTP studies in mice and F344/N rats. Erosions are seen primarily in treated rats. An erosion ( Figure 1 and Figure 2 ) is a partial thickness of epithelial loss, compared with an ulcer (see Stomach, Glandular Stomach - Ulcer ), in which the entire epithelial thickness has been lost down to or through the basement membrane and muscularis mucosa. In comparison, necrosis of epithelium is diagnosed instead of erosion if the necrotic portion of the epithelium is still present and at least partially attached to the underlying viable epithelium. Bacterial infections can occur secondary to erosion or ulceration due to local trauma from a gavage procedure or necrosis/ischemia. Indigenous bacteria in the stomach of the rat are normally found adherent to only the most luminal mucosa but not in the gastric pits. Following erosion/ulceration, bacteria can gain access to deeper portions of the mucosa and stomach wall. Compounds that produce erosions and ulcers can act via effects on mucosal blood flow, mucosal cell kinetics, mucus or acid/bicarbonate secretion, or maintenance of the mucus barrier. High-fat diets, chronic pantothenic acid deficiency, deficiency of gluconeogenic amino acids, platelet-activating factor, increased reflux of bile salts, and reduced exocrine pancreatic function are associated with ulceration but only with intact vagal innervations. The mediators of ulceration may be metabolites of the lipooxygenase pathway of arachidonic acid metabolism. Age of maternal separation of rat pups from their mothers has been reported to affect susceptibility to development of immobilization-induced gastric erosions.

Recommendation:
Erosion of the glandular stomach should be diagnosed and graded based on the extent and distribution of the lesions. Edema, inflammation, and hyperplasia of the adjacent epithelium should not be diagnosed separately unless they are a prominent component of the lesion. Necrosis of epithelium is diagnosed instead of erosion if the necrotic epithelium is still present and at least partially attached to the underlying viable epithelium. Related Links: Stomach, Glandular Stomach - Ulcer

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/alimentary-system/stomach-glandular-stomach/Erosion

图谱总目录:NTP Nonneoplastic Lesion Atlas。 内容属美国联邦政府作品(公有领域),可引用;引用时请标注来源。

建议引用格式:NTP Nonneoplastic Lesion Atlas. Erosion (stomach-glandular-stomach). LabSmart 中文版: https://www.labsmart.cn/ntp/stomach-glandular-stomach-erosion.html

中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#stomach-glandular-stomach-erosion

上皮增生上皮细胞质空泡化上皮非典型增生出血囊肿坏死